SOW - exam tables (004).pdf

Department of Health and Human Services Indian Health Service

Clinton Indian Health Center

Statement of Work (SOW) Watonga Exam Tables

1. PURPOSE OF THE PROJECT

The purpose of this contract is to provide new exam tables to replace end of life equipment for the Clinton Service Unit (CSU) that is comprised of the Clinton Indian Health Center (CIHC), El Reno Indian Health Center (EIHC) and Watonga Indian Health Center (WIHC). The CSU facilities are outpatient federal facilities that provide ambulatory care for eligible Native American patients that are registered for services. To meet the CSU’s mission, CSU requires the procurement of five (5) new exam tables to replace end of life equipment.

2. DETAILED DESCRIPTION OF THE TECHNICAL REQUIREMENTS

The contractor shall provide all materials and transportation associated with the delivery of exam tables, equivalent or equal to the following specifications:

2.1. QTY - Four (4) - Midmark 225 Ritter Barrier-Free Exam Tables.

2.2. QTY – One (1) - Midmark 630 Human Form Procedure Chair.

2.3. QTY- Four (4) –MI-002-2008-XXX Upholstery Top - 224/225 28" Flat Upholstery Top – Seamless or equal.

2.4. QTY- One (1) – MI -002-10112-xxx Upholstery Top – 630 – 32” Premium or equal.

2.5. All supplies, materials, and equipment shall be new.

2.6. Vendor shall provide a (1) year warranty on the exam tables, components, and upholstery.

If an equal brand is offered then, that brand shall meet or exceed the following specifications.

2.a. SPECIFICATIONS 225 Ritter Barrier-Free™ Exam Table, w/Drawer Heater, Pelvic Tilt & Electrical Receptacle-Base Only or equal

• Power height, Power backrest

• Patient Transfer Position (PTP): must have low FLAT back position at 18” for true safe patient

• Meets US Access Board recommendations for accessibility with 18” uncompressed low seat height

• 500 lb. lifting capacity

• Manually engagement of actuator to lower table if power outage

• Optional patient support rails plus to achieve proper positioning of patients’ arm for blood pressure capture - handling and wheelchair transfer, 59” long x 28” wide transfer area

• Chair position or flat table position at any height

• 76” long patient surface with slide-out footrest extended

• Active sensing technology safety feature to pause movement when disrupting impact is detected

• Front storage drawer with dividers for access/storage of speculums, gloves, instruments and supplies

• Paper roll storage

• Multi-position hideaway stirrups

• Pelvic tilt and drawer heater

• Treatment pan

• Smooth-start electromechanical actuator motors- Tamper resistant, UL-listed, duplex, hospital-grade electrical receptacles

• Seamless upholstery for cleaning/infection prevention

• Removable upholstery top system for cleaning and easy replacement

• Steel-on-steel construction on all weight-bearing points for durability, including steel-reinforced seat and back section

Clinton Indian Health Center

• Seamless/sealed foot control for cleaning/infection prevention

• Standard spline receptacle system for tools free plug-n play attachment of accessories patient support rails and patient support rails plus - Galvanized leveling feet

• Mist base color; Stone molded accents

• UL-listed

MI-002-2008-XXX Upholstery Top - 224/225 28" Flat Upholstery Top – Seamless or equal.

Midmark 630 Human Form Procedure Chair, Programmable w/Electrical or equal

• Power height, power backrest, power Trendelenburg tilt, power footrest

• 18" low height, 40" high height

• 650 lb. lifting capacity

• Patient Transfer Position (PTP): must have FLAT-back position at 18" for true safe patient handling and wheelchair transfer; 72" long x 28" wide transfer area

• 4 programmable memory positions

• Chair position or flat table position at any height

• 72" - 76" long x 28" wide patient surface

• Motion Profiling® designed to provide more natural, humanlike movement

• Active Sensing Technology® (AST) designed to actively protect patient and provider by sensing and avoiding harmful impact during movement

• Interchangeable headrest system (no tools needed) - Adjustable, removable standard headrest, 4 other headrest options available.

• Removable, laterally-articulating padded armrests for patient transfer, repositioning and safety

• Paper roll holder

• Quick-Chair™/Auto-return button

• Smooth-start electromechanical actuator motors

• Premium Comfort System® - elastomeric seat cutout for patient comfort

• Two UL-listed, duplex, hospital-grade electrical receptacles

• (non-rotation models only)

• Multi-position hideaway stirrups

• Stainless steel treatment pan

• Seamless upholstery for cleaning/infection control- Removable upholstery top system for cleaning and easy replacement (no tools needed)

• Steel-on-steel construction on all weight-bearing points for durability

• Hand and foot control standard

• Seamless/sealed foot control for cleaning/infection control

• Accessory rails standard

• Over 30+ accessories available for customizability

• Pebble Grey base color; Pearl Grey molded accents

• UL-listed

MI -002-10112-xxx Upholstery Top – 630 – 32” Premium or equal.

3. PERIOD OF PERFORMANCE

Clinton Indian Health Center

30 days from date of award

4. LEVEL OF EFFORT

4.1. The contractor shall provide all materials and transportation associated with the delivery of the equipment specified within this

SOW.

4.2. All supplies, materials, and equipment shall be new.

4.3. Vendor shall provide a (1) year warranty on the exam tables, components, and upholstery.

5. SPECIAL REQUIREMENTS

5.1. The US PHS Clinton Indian Health Center is a tobacco/smoke free environment (buildings and grounds). No tobacco/smoking use will be tolerated during service.

5.2. Security Requirements: Contractor personnel will be required to contact the government designated point of contact upon arrival when reporting for service calls or delivery of supplies. The contractor shall be responsible for the security of all organizational information. Current rules and regulations applicable to the premises, where the work shall be performed shall apply to the contractor and its employees while working on the premises. These regulations include but are not limited to, escort by Clinton Service Unit official, presenting valid identification, smoking restriction and any safety procedures.

5.3. The contractor shall not disclose or cause to disseminate any information concerning operations of Clinton Service Unit. Such action(s) could result in violation of the contract and possible legal actions.

5.3.1. All inquiries, comments, or complaints arising from any matter observed, experienced or learned of as a result of or in connection with the performance of the contract, the resolution of which may require the dissemination of official information, shall be directed to the government’s designated representative.

6. DELIVERABLES AND REPORTING REQUIREMENTS

6.1. Delivery: The contractor will coordinate the delivery date with the designated government employee. The government will provide the contractor with dock access and building access for this sole purpose. The designated government employee will work with the pertinent government agency(ies) to secure the needed dock access. No deliveries can be made after 4:15pm.

Driver needs a valid ID.

6.1.1. Location information as the following:

6.1.1.1. Clinton Indian Health Center: 10321 N. 2274 Rd, Clinton, OK 73601 – Dock Access

6.1.1.2. El Reno Indian Health Center: 1801 Parkview Dr, El Reno, OK 73036 – No dock, would require lift gate for shipments.

6.1.1.3. Watonga Indian Health Center: 1305 S. Clarence Nash Blvd, Watonga, OK 73772 – No dock, would require lift gate for shipments.

6.2. Contractor Point of Contact: The contractor shall furnish one designated point of contact (POC) to the government’s designated representative for coordination of supplies, delivery, and/or maintenance. The POC will be empowered to make daily decisions to ensure that the contract implementation and day-to-day maintenance meets the terms and conditions of this contract.

6.3. Contractor’s Phone Numbers: The contractor shall provide a toll-free telephone number for service calls, which must be answered during at least eight working hours, between 8:00 am and 4:30 pm, Monday through Friday.

7. GOVERNMENT FURNISHED PROPERTY, FACILITIES AND SERVICES

Clinton Indian Health Center

7.1. The Government shall make NO supply of property, facilities, or services.

8. CONTRACTOR FURNISHED PROPERTY, FACILITIES AND SERVICES

8.1. The contractor shall furnish all personnel, materials, supplies and equipment required to perform work under the contract.

9. CHANGES TO THE STATEMENT OF WORK (SOW)

Any changes to this SOW shall be authorized and approved only through written correspondence from the Contracting Officer. Costs incurred by the contractor through the actions of parties other than the Contracting Officer shall be borne by the contractor.

10. DELIVERABLES/PERFORMANCE MATRIX

Measureables to be evaluated at the conclusion of awarded contract:

Equipment provided met specifications or equivalent. YES NO N/A

Invoice(s) submitted timely and accurately. YES NO N/A

Delivery was coordinated as specified. YES NO N/A

Period of Performance – contract deliverables were met as specified. YES NO N/A

Warranty – Contractor fulfilled warranty obligations as specified. YES NO N/A

Comments:

Department Supervisor Signature: _______________________________

Administrative Officer Signature: _______________________________

Jeff C. Blackmon -S

Digitally signed by Jeff C.

Blackmon -S Date: 2025.05.22 07:44:29 -05'00'

Tina M. Scott -S Digitally signed by Tina M. Scott -S Date: 2025.05.22 11:07:42 -05'00'